1. Field of the Invention
This invention relates to an adjustable, portable, light, dual-sized, folding board for use in the positional treatment of gastroesophageal reflux and its complications in incubator-bound prematures and fullterm infants in standard cribs.
2. Background
Gastroesophageal reflux (GER) may be defined as the reverse flow of gastric contents into the esophagus. While reflux is quite common in infants, two out of every hundred infants will have prolonged problematic reflux, and one per two hundred will have medically significant reflux inviting failure to thrive, esophagitis, aspiration, and even apnea and bradycardia.sup.1. It is well known that children with developmental delay and/or significant neurological disease have an increased incidence of GER.sup.2. GER is therefore a potentially serious medical disorder requiring treatment. The current modalities employed for GER are smaller, more frequent and thickened feedings, pro-motility drugs (bethanechol, metoclopramide), and positional therapy.sup.3.
Positional therapy has been shown to have good results in alleviating the symptoms and discomforts of GER. The infant must be placed in a prone position.sup.4 --NOT supine--of from between 30 to 45 degree angles. The flexibility to adjust the angle is important, since there are variable degrees of GER. These are defined by the level where GER occurs in a patient's esophagus, the duration of the episode, and the gastric emptying time. Infants who have high level reflux events reaching the upper third of the esophagus require a higher degree of verticality, as do infants who have reflux events of long duration (greater than eight to ten seconds). Infants who have prolonged gastric emptying time require a longer interval of verticality, although not necessarily a higher degree of angle. These variables may differ at different times with the same infant. Positional therapy in which an infant is inclined towards a vertical angle must therefore be able to adapt to the individual needs of afflicted infants.
The positioning of the infant must be accomplished safely, eliminating the possibility of the infant choking, or rolling off the board. It must allow movement as unencumbered as possible since the infant will require long term positional therapy for this condition. In the event of a medical emergency, it must be possible to effect an easy and fast exit. At all other times the caretaker should have unrestricted and convenient access to the infant.